Increased urinary nitrite, a marker of nitric oxide, in active inflammatory bowel disease.

BACKGROUND: Nitric oxide (NO) production is increased in inflammatory bowel disease (IBD), and measurement of NO metabolites may be useful for monitoring disease activity. AIMS AND OBJECTIVES: To characterise urinary nitrite levels, a stable metabolite of NO, in IBD and to evaluate its potential as a marker of disease activity. METHODS: Twelve-hour urinary nitrites were measured by the microplate assay method in 46 patients with IBD (active; n = 32). Urinary samples from 16 healthy individuals served as controls. RESULTS: Increased levels of urinary nitrites were found in patients with active IBD compared with those with inactive IBD. Twenty-eight out of 32 patients (87.5%) with active IBD had detectable levels of nitrite in their urine as compared with 2/14 (14.3%) patients with inactive IBD. None of the 16 healthy controls had detectable urinary nitrite. Twelve-hour urinary nitrite in active compared with inactive IBD: 5 0.7 versus 0.1+/-0.04 micromol (P < 0.05). There was good correlation between urinary nitrite and some markers of disease activity in IBD such as C-reactive protein and microalbuminuria but not with erythrocyte sedimentation rate. Conclusions: Increased levels of nitrite were detected in urine of patients with active IBD, consistent with increased NO synthesis. This simple assay may be exploited as a potential marker of disease activity in IBD

Validation of Multicultural Counselling Competencies Scale among Malaysian Counsellor Trainees: A Confirmatory Factor Analysis

The competency of multicultural counselling is an aspect which needs to be mastered by a counsellor in order to provide good counselling services to clients especially when dealing with clients of different culture. The purpose of this research is to examine the validity and reliability of the Multicultural Counselling Competencies Scale which was developed based on the local culture by using confirmatory factor analysis (CFA). A total of 290 final year students participating in the first-degree counselling program from six public universities were selected randomly. The results of the analysis showed that the fit value for the comparative fit index (CFI), Tucker Lewis index (TLI), and normed fit index (NFI) respectively had fulfilled the fit value of 0.90 and above as suggested by the literature. The analysis also showed the average variance extracted (AVE) values for all three constructs were 0.669 (awareness), 0.764 (skills) and 0.642 (knowledge) respectively, indicating the validity convergent and discriminant reliability were achieved. CFA analysis has removed 7 out of 26 original items due to low loading factor. Overall, CFA analysis has successfully proven that competencies of multicultural counselling questionnaire as a multidimensional construct as it has been theorized and is appropriate for measuring the competencies of multicultural counselling in Malaysia

Medication adherence during adjunct therapy with statins and ACE inhibitors in adolescents with type 1 diabetes

OBJECTIVE: Suboptimal adherence to insulin treatment is a main issue in adolescents with type 1 diabetes. However, to date, there are no available data on adherence to adjunct noninsulin medications in this population. Our aim was to assess adherence to ACE inhibitors and statins and explore potential determinants in adolescents with type 1 diabetes. RESEARCH DESIGN AND METHODS:There were 443 adolescents with type 1 diabetes recruited into the Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT) and exposed to treatment with two oral drugs—an ACE inhibitor and a statin—as well as combinations of both or placebo for 2–4 years. Adherence was assessed every 3 months with the Medication Event Monitoring System (MEMS) and pill count. RESULTS: Median adherence during the trial was 80.2% (interquartile range 63.6–91.8) based on MEMS and 85.7% (72.4–92.9) for pill count. Adherence based on MEMS and pill count dropped from 92.9% and 96.3%, respectively, at the first visit to 76.3% and 79.0% at the end of the trial. The percentage of study participants with adherence ≥75% declined from 84% to 53%. A good correlation was found between adherence based on MEMS and pill count (r = 0.82, P < 0.001). Factors associated with adherence were age, glycemic control, and country. CONCLUSIONS: We report an overall good adherence to ACE inhibitors and statins during a clinical trial, although there was a clear decline in adherence over time. Older age and suboptimal glycemic control at baseline predicted lower adherence during the trial, and, predictably, reduced adherence was more prevalent in subjects who subsequently dropped out

Bose-Einstein condensates in a double well: mean-field chaos and multi-particle entanglement

A recent publication [Phys. Rev. Lett. 100, 140408 (2008)] shows that there is a relation between mean-field chaos and multi-particle entanglement for BECs in a periodically shaken double well. 'Schrodinger-cat' like mesoscopic superpositions in phase-space occur for conditions for which the system displays mean-field chaos. In the present manuscript, more general highly-entangled states are investigated. Mean-field chaos accelerates the emergence of multi-particle entanglement; the boundaries of stable regions are particularly suited for entanglement generation.Comment: 5 Pages, 5 jpg-figures, to be published in the proceedings of the LPHYS0

Can birth outcome inequality be reduced using targeted caseload midwifery in a deprived diverse inner city population? A retrospective cohort study, London, UK.

Objectives(1) To report maternal and newborn outcomes of pregnant women in areas of social deprivation in inner city London. (2) To compare the effect of caseload midwifery with standard care on maternal and newborn outcomes in this cohort of women.DesignRetrospective observational cohort study.SettingFour council wards (electoral districts) in inner city London, where over 90% of residents are in the two most deprived quintiles of the English Index of Multiple Deprivation (IMD) (2019) and the population is ethnically diverse.ParticipantsAll women booked for antenatal care under Guys and St Thomas' National Health Service Foundation Trust after 11 July 2018 (when the Lambeth Early Action Partnership (LEAP*) caseload midwifery team was implemented) until data collection 18 June 2020. This included 523 pregnancies in the LEAP area, of which 230 were allocated to caseload midwifery, and 8430 pregnancies from other areas.Main outcome measuresTo explore if targeted caseload midwifery (known to reduce preterm birth) will improve important measurable outcomes (preterm birth, mode of birth and newborn outcomes).ResultsThere was a significant reduction in preterm birth rate in women allocated to caseload midwifery, when compared with those who received traditional midwifery care (5.1% vs 11.2%; risk ratio: 0.41; p=0.02; 95% CI 0.18 to 0.86; number needed to treat: 11.9). Caesarean section births were significantly reduced in women allocated to caseload midwifery care, when compared with traditional midwifery care (24.3% vs 38.0%; risk ratio: 0.64: p=0.01; 95% CI 0.47 to 0.90; number needed to treat: 7.4) including emergency caesarean deliveries (15.2% vs 22.5%; risk ratio: 0.59; p=0.03; 95% CI 0.38 to 0.94; number needed to treat: 10) without increase in neonatal unit admission or stillbirth.ConclusionThis study shows that a model of caseload midwifery care implemented in an inner city deprived community improves outcome by significantly reducing preterm birth and birth by caesarean section when compared with traditional care. This data trend suggests that when applied to targeted groups (women in higher IMD quintile and women of diverse ethnicity) that the impact of intervention is greater

Enhancing biofeedback-driven self-guided virtual reality exposure therapy through arousal detection from multimodal data using machine learning

Virtual reality exposure therapy (VRET) is a novel intervention technique that allows individuals to experience anxiety-evoking stimuli in a safe environment, recognise specific triggers and gradually increase their exposure to perceived threats. Public-speaking anxiety (PSA) is a prevalent form of social anxiety, characterised by stressful arousal and anxiety generated when presenting to an audience. In self-guided VRET, participants can gradually increase their tolerance to exposure and reduce anxiety-induced arousal and PSA over time. However, creating such a VR environment and determining physiological indices of anxiety-induced arousal or distress is an open challenge. Environment modelling, character creation and animation, psychological state determination and the use of machine learning (ML) models for anxiety or stress detection are equally important, and multi-disciplinary expertise is required. In this work, we have explored a series of ML models with publicly available data sets (using electroencephalogram and heart rate variability) to predict arousal states. If we can detect anxiety-induced arousal, we can trigger calming activities to allow individuals to cope with and overcome distress. Here, we discuss the means of effective selection of ML models and parameters in arousal detection. We propose a pipeline to overcome the model selection problem with different parameter settings in the context of virtual reality exposure therapy. This pipeline can be extended to other domains of interest where arousal detection is crucial. Finally, we have implemented a biofeedback framework for VRET where we successfully provided feedback as a form of heart rate and brain laterality index from our acquired multimodal data for psychological intervention to overcome anxiety

Critical number of atoms in an attractive Bose-Einstein condensate on an optical plus harmonic traps

The stability of an attractive Bose-Einstein condensate on a joint one-dimensional optical lattice and an axially-symmetric harmonic trap is studied using the numerical solution of the time-dependent mean-field Gross-Pitaevskii equation and the critical number of atoms for a stable condensate is calculated. We also calculate this critical number of atoms in a double-well potential which is always greater than that in an axially-symmetric harmonic trap. The critical number of atoms in an optical trap can be made smaller or larger than the corresponding number in the absence of the optical trap by moving a node of the optical lattice potential along the axial direction of the harmonic trap. This variation of the critical number of atoms can be observed experimentally and compared with the present calculation.Comment: Latex with 7 eps figures, Accepted in Journal of Physics

Fish farming in Tanzania: the availability and nutritive value of local feed ingredients

An investigative field survey was performed to gather baseline data on locally available feed ingredients and fish farming practices in different regions of Tanzania. More than 80% of respondents relied on locally available feed ingredients as a major feed supplement for their cultured fish, with maize bran being the most commonly used feed ingredient in all regions. Crude protein content in most analyzed local feed ingredients was medium-high, while crude fat content was high in some animal and agricultural by-products, and medium-low in other ingredients. Most respondents were males and the majority of fish farms were owned by individuals. Earthen pond was the most common fish farming system in all regions except Dar es Salaam. Semi-intensively mixed-sex tilapia monoculture was the dominating fish farming practice. The results of the survey presented provide a good platform for future development of culture systems and feeding strategies for tilapia in Tanzania